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Botswana First report of Unusual Parasitic Disease
Monday, 17 November, 2008
Scientists at the National Institute for Communicable Diseases National Health Laboratory Service in Johannesburg, South Africa have identified 2 separate clusters of gnathostomiasis acquired in the Okavango Delta, Botswana, with a total of 8 confirmed or probable cases. Both outbreaks (one in August, one in November 2008) occurred in groups of people who ate raw, marinated bream (_Tilapia_ species). After non-specific malaise and/or gastrointestinal discomfort, some exposed individuals presented with recurrent episodes of painful migratory skin nodules and transient urticaria. Several small worms were extracted from localised skin lesions, which were identified as larvae of a _Gnathostoma_ species. These nematode parasites have a complicated life cycle involving a variety of hosts. Humans become infected when they eat raw or undercooked fish, crabs or crayfish, but also rarely from undercooked poultry and reportedly by drinking water containing Cyclops – microscopic creatures – infected with larvae.
Gnathostomiasis is well-known in Southeast Asia and Central and South America and is regarded as an emerging imported disease resulting from increasing international travel and adventurous eating. This is the first description of the disease from Botswana; the only other recognised outbreak in the region occurred on the Zambezi River in western Zambia.
